Annals of Surgical Oncology

, Volume 20, Issue 4, pp 1360–1364 | Cite as

A Collision of Diseases: Chronic Lymphocytic Leukemia Discovered During Lymph Node Biopsy for Melanoma

  • Jeffrey M. Farma
  • Jonathan S. Zager
  • Victor Barnica-elvir
  • Christopher A. Puleo
  • Suroosh S. Marzban
  • Dana E. Rollison
  • Jane L. Messina
  • Vernon K. Sondak
Melanomas

ABSTRACT

Background

In the United States in 2012, there were 16,060 new cases of chronic lymphocytic leukemia (CLL). Often CLL is clinically occult and first detected during pathologic evaluation of the sentinel lymph node biopsy (SLNB). We reviewed our experience of patients with the coexisting diagnosis of melanoma and CLL.

Methods

An institutional review board-approved review was performed on patients with CLL and melanoma treated from 1995 to 2009 at Moffitt Cancer Center and compared with the incidence of melanoma and CLL in our tumor registry patients with breast, prostate, lung, and colon cancer.

Results

Fifty-two patients (44 males; median age, 71 years [range, 46–88]) were identified with concurrent diagnoses of melanoma and CLL. Twenty-two patients (42 %) had CLL on SLNB for their melanoma. Thirty-two patients (62 %) were diagnosed with melanoma before CLL. Concomitant or prior cancer diagnoses included nonmelanoma skin cancers (N = 29), prostate (N = 6), colorectal (N = 2), and Merkel cell carcinoma (N = 2). Five of 20 patients (25 %) had metastatic melanoma found at the time of SLNB. Patients with melanoma had a tenfold increase of CLL diagnosis compared with colorectal cancer patients, an eightfold increase compared to prostate cancer patients, and a fourfold increase compared with breast cancer patients.

Conclusions

We have confirmed an increased association of CLL and melanoma. This may be related to an underlying immunologic defect; however, there has been scant investigation into this phenomenon. Surgeons and pathologists should understand this occurrence and recognize that not all grossly enlarged or abnormal sentinel lymph nodes in melanoma patients represent melanoma.

REFERENCES

  1. 1.
    Siegel R, Desantis C, Virgo K, et al. Cancer treatment and survivorship statistics, 2012. CA Cancer J Clin. 2012;62(4):220–41.PubMedCrossRefGoogle Scholar
  2. 2.
    Cahill RA, McGreal G, Neary P, Redmond HP. Synchronous high-risk melanoma and lymphoid neoplasia. Melanoma Res. 2001;11(5):517–22.PubMedCrossRefGoogle Scholar
  3. 3.
    Manusow D, Weinerman BH. Subsequent neoplasia in chronic lymphocytic leukemia. JAMA. 1975;232(3):267–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Greene MH, Hoover RN, Fraumeni JF Jr. Subsequent cancer in patients with chronic lymphocytic leukemia: a possible immunologic mechanism. J Natl Cancer Inst. 1978;61(2):337–40.PubMedGoogle Scholar
  5. 5.
    Royle JA, Baade PD, Joske D, Girschik J, Fritschi L. Second cancer incidence and cancer mortality among chronic lymphocytic leukaemia patients: a population-based study. Br J Cancer. 2011;105(7):1076–81.PubMedCrossRefGoogle Scholar
  6. 6.
    Verwer N, Murali R, Winstanley J, et al. Lymphoma occurring in patients with cutaneous melanoma. J Clin Pathol. 2010;63(9):777–81.PubMedCrossRefGoogle Scholar
  7. 7.
    Ross MI, Thompson JF, Gershenwald JE. Sentinel lymph node biopsy for melanoma: critical assessment at its twentieth anniversary. Surg Oncol Clin N Am. 2011;20(1):57–78.PubMedCrossRefGoogle Scholar
  8. 8.
    El Demellawy D, Ross C, Sur M, Alowami S. Synchronously diagnosed lymph nodal collision tumor of malignant melanoma and chronic lymphocytic leukemia/small lymphocytic lymphoma: case report. Diagn Pathol. 2007;2:34.PubMedCrossRefGoogle Scholar
  9. 9.
    Adami J, Frisch M, Yuen J, Glimelius B, Melbye M. Evidence of an association between non-Hodgkin’s lymphoma and skin cancer. BMJ. 1995;310(6993):1491–5.PubMedCrossRefGoogle Scholar
  10. 10.
    Landgren O, Pfeiffer RM, Stewart L, et al. Risk of second malignant neoplasms among lymphoma patients with a family history of cancer. Int J Cancer. 2007;120(5):1099–102.PubMedCrossRefGoogle Scholar
  11. 11.
    Brennan P, Coates M, Armstrong B, Colin D, Boffetta P. Second primary neoplasms following non-Hodgkin’s lymphoma in New South Wales, Australia. Br J Cancer. 2000;82(7):1344–7.PubMedCrossRefGoogle Scholar
  12. 12.
    Travis LB, Curtis RE, Glimelius B, et al. Second cancers among long-term survivors of non-Hodgkin’s lymphoma. J Natl Cancer Inst. 1993;85(23):1932–7.PubMedCrossRefGoogle Scholar
  13. 13.
    Brennan P, Scelo G, Hemminki K, et al. Second primary cancers among 109 000 cases of non-Hodgkin’s lymphoma. Br J Cancer. 2005;93(1):159–66.PubMedCrossRefGoogle Scholar
  14. 14.
    Hisada M, Biggar RJ, Greene MH, Fraumeni JF Jr, Travis LB. Solid tumors after chronic lymphocytic leukemia. Blood. 2001;98(6):1979–81.PubMedCrossRefGoogle Scholar
  15. 15.
    Riou JP, Ariyan S, Brandow KR, Fielding LP. The association between melanoma, lymphoma, and other primary neoplasms. Arch Surg. 1995;130(10):1056–61.PubMedCrossRefGoogle Scholar
  16. 16.
    Tsimberidou AM, Wen S, McLaughlin P, et al. Other malignancies in chronic lymphocytic leukemia/small lymphocytic lymphoma. J Clin Oncol. 2009;27(6):904–10.PubMedCrossRefGoogle Scholar
  17. 17.
    Agnew KL, Ruchlemer R, Catovsky D, Matutes E, Bunker CB. Cutaneous findings in chronic lymphocytic leukaemia. Br J Dermatol. 2004;150(6):1129–35.PubMedCrossRefGoogle Scholar
  18. 18.
    McKenna DB, Stockton D, Brewster DH, Doherty VR. Evidence for an association between cutaneous malignant melanoma and lymphoid malignancy: a population-based retrospective cohort study in Scotland. Br J Cancer. 2003;88(1):74–8.PubMedCrossRefGoogle Scholar
  19. 19.
    Balamurugan A, Rees JR, Kosary C, Rim SH, Li J, Stewart SL. Subsequent primary cancers among men and women with in situ and invasive melanoma of the skin. J Am Acad Dermatol. 2011;65(5 Suppl 1):S69–77.PubMedGoogle Scholar
  20. 20.
    Brewer JD, Shanafelt TD, Otley CC, et al. Chronic lymphocytic leukemia is associated with decreased survival of patients with malignant melanoma and Merkel cell carcinoma in a SEER population-based study. J Clin Oncol. 2012;30(8):843–9.PubMedCrossRefGoogle Scholar

Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Jeffrey M. Farma
    • 1
  • Jonathan S. Zager
    • 2
  • Victor Barnica-elvir
    • 1
  • Christopher A. Puleo
    • 2
  • Suroosh S. Marzban
    • 2
  • Dana E. Rollison
    • 3
  • Jane L. Messina
    • 2
    • 4
  • Vernon K. Sondak
    • 2
  1. 1.Department of Surgical OncologyFox Chase Cancer CenterPhiladelphiaUSA
  2. 2.Department of Cutaneous OncologyMoffitt Cancer CenterTampaUSA
  3. 3.Department of Cancer EpidemiologyMoffitt Cancer CenterTampaUSA
  4. 4.Department of Pathology & Cell BiologyUniversity of South Florida Morsani College of MedicineTampaUSA

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